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Rikitarwa na ciki

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Rikitarwa na ciki
Description (en) Fassara
Iri complication of pregnancy, childbirth and the puerperium (en) Fassara
complication (en) Fassara
Field of study (en) Fassara Obstetrics
Sanadi Ciki
Identifier (en) Fassara
ICD-10 O26.9
ICD-9 630, 631, 632, 633, 634, 635, 636, 637, 638, 639, 640, 641, 642, 643, 644, 645, 646, 647, 648 da 646.1
MeSH D011248

Matsalolin ciki matsalolin lafiya ne da suka shafi ko kuma suka taso yayin daukar ciki . Matsalolin da ke faruwa musamman a lokacin haihuwa ana kiransu matsalolin haihuwa, kuma matsalolin da ke faruwa musamman bayan haihuwa ana kiransu matsalolin haihuwa . Duk da cewa wasu matsaloli suna inganta ko kuma an magance su gaba daya bayan daukar ciki, wasu na iya haifar da sakamako mai ɗorewa, rashin lafiya, ko kuma a mafi munin yanayi, mutuwar uwa ko tayi. [1] [2] [3]

Matsalolin da ake yawan samu a cikin daukar ciki sun hada da karancin jini, ciwon suga na ciki, kamuwa da cuta, hawan jini na ciki, da kuma pre-eclampsia . [4] Kasancewar irin wadannan matsaloli na iya yin tasiri ga sa ido kan aikin dakin gwaje-gwaje, daukar hoto, da kuma kula da lafiya a lokacin daukar ciki. [5]

Matsaloli masu tsanani na ciki, haihuwa, da kuma lokacin haihuwa suna faruwa a cikin kashi 1.6% na iyaye mata a Amurka, [6] da kuma kashi 1.5% na iyaye mata a Kanada. [7] A lokacin haihuwa nan take (puerperium), kashi 87% zuwa 94% na mata sun ba da rahoton aƙalla wata matsala ta lafiya. [8] [9] Kashi 31% na mata ne suka ba da rahoton matsalolin lafiya na dogon lokaci (na ci gaba bayan watanni shida bayan haihuwa). [10]

A shekarar 2016, matsalolin da suka shafi daukar ciki, haihuwa, da kuma lokacin haihuwa sun haifar da mutuwar mutane 230,600 a duk duniya, wanda ya ragu daga mutuwar mutane 377,000 a shekarar 1990. Abubuwan da suka fi haifar da mace-macen mata masu juna biyu sune zubar jini a lokacin haihuwa, kamuwa da cututtukan bayan haihuwa, ciki har da sepsis, cututtukan hawan jini na ciki, nakuda, da kuma zubar da ciki mara aminci. [11] [12]

Matsalolin ciki na iya tasowa a wasu lokutan daga bayyanar cututtuka masu tsanani da rashin jin daɗi na ciki, waɗanda yawanci ba sa tsoma baki sosai ga ayyukan yau da kullun ko kuma suna haifar da wata babbar barazana ga lafiyar mace ko tayin. Misali, rashin lafiyar safe wata alama ce mai sauƙi ta ciki wadda galibi take ɓacewa a cikin watanni uku na biyu na ciki, amma hyperemesis gravidarum wata cuta ce mai tsanani ta wannan alamar wadda wani lokacin take buƙatar taimakon likita don hana rashin daidaiton electrolyte daga amai mai tsanani.

Matsalolin uwaye

[gyara sashe | gyara masomin]

Matsalolin da ke ƙasa suna samo asali ne daga uwa; duk da haka, suna iya haifar da mummunan sakamako ga tayin.

Ciwon suga na lokacin daukar ciki

[gyara sashe | gyara masomin]

Ciwon suga na lokacin daukar ciki shine lokacin da mace, ba tare da an gano ta a baya ba, ta kamu da yawan sukari a jini yayin daukar ciki . [13] [14] Akwai abubuwa da yawa da ba za a iya canzawa ba kuma wadanda za a iya canzawa wadanda ke haifar da wannan matsala. Abubuwan da ba za a iya canzawa ba sun hada da tarihin iyali na ciwon suga, shekarun uwa, da kuma kabila. Abubuwan da za a iya canzawa sun hada da kiba a lokacin daukar ciki. [14] Akwai karuwar bukatar insulin a lokacin daukar ciki wanda ke haifar da karuwar samar da insulin daga kwayoyin halittar beta na pancreas . Yawan bukatar yana faruwa ne sakamakon karuwar yawan kalori na uwa, karuwar nauyi, da karuwar samar da prolactin da hormone na girma. Ciwon suga na lokacin daukar ciki yana kara hadarin kara matsalolin uwa da tayi kamar ci gaban pre-eclampsia, bukatar haihuwar caesarean, haihuwa kafin lokacin haihuwa, polyhydramnios, macrosomia, dystocia na kafada, karancin jini a cikin tayin, hyperbilirubinemia, da kuma shiga sashin kulawa mai zurfi na jarirai. Karin hadarin yana da alaƙa da yadda ake sarrafa ciwon suga na lokacin daukar ciki yayin daukar ciki, tare da rashin kulawa mai kyau da ke da alaƙa da mummunan sakamako. Ana amfani da wata hanya mai fannoni daban-daban don magance ciwon suga na lokacin daukar ciki. Ya ƙunshi sa ido kan matakan glucose na jini, gyare-gyaren abinci mai gina jiki da abinci, canje-canjen salon rayuwa kamar ƙara yawan motsa jiki, kula da nauyin uwa, da magunguna kamar insulin. [14]

Ciwon hyperemesis gravidarum

[gyara sashe | gyara masomin]

Hyperemesis gravidarum shine kasancewar amai mai tsanani da na dindindin, wanda ke haifar da bushewar jiki da rage kiba. Yana kama da haka, kodayake ya fi tsanani fiye da ciwon safe da aka saba gani. [15] [16] An kiyasta yana shafar kashi 0.3–3.6% na mata masu juna biyu kuma shine babban mai ba da gudummawa ga asibiti a ƙasa da makonni 20 na ciki. Mafi yawan lokuta, alamun tashin zuciya da amai a lokacin daukar ciki ana magance su a farkon watanni uku na ciki; duk da haka, wasu suna ci gaba da fuskantar alamun. Ana gano hyperemesis gravidarum ta hanyar waɗannan sharuɗɗa: fiye da lokutan amai 3 a rana, ketonuria, da kuma asarar nauyi fiye da 3 kg ko kashi 5% na nauyin jiki. Abubuwa da dama da ba za a iya canzawa ba kuma waɗanda za a iya gyarawa suna sanya mata cikin wannan yanayin, kamar tayin ciki na mace, tarihin cututtukan tabin hankali, BMI mai yawa ko ƙasa kafin daukar ciki, ƙuruciya, ƙabilar Ba'amurke ko Asiya, ciwon suga na nau'in I, ɗaukar ciki da yawa, da tarihin ɗaukar ciki da hyperemesis gravidarum ya shafa. A halin yanzu babu wata hanyar da aka sani game da dalilin wannan yanayin. Wannan rikitarwa na iya haifar da ƙarancin abinci mai gina jiki, ƙarancin nauyin ciki, bushewar jiki, da rikicewar bitamin, electrolyte, da acid a cikin uwa. An nuna cewa yana haifar da ƙarancin nauyin haihuwa, ƙaramin girma ga shekarun daukar ciki, haihuwar da ba ta yi ba, da kuma ƙarancin maki na APGAR a cikin jariri. Maganin wannan yanayin yana mai da hankali kan hana cutar da tayin yayin da yake inganta alamun cutar kuma galibi ya haɗa da maye gurbin ruwa da shan ƙananan abinci, akai-akai, marasa laushi. Magungunan farko sun haɗa da citta da acupuncture. Magungunan na biyu sun haɗa da bitamin B 6 ± doxylamine, antihistamines, dopamine antagonists, da serotonin antagonists. Magungunan na uku sun haɗa da corticosteroids, transdermal clonidine, da gabapentin. Maganin da aka zaɓa ya dogara ne akan tsananin alamun cutar da kuma yadda ake mayar da martani ga magunguna. [17]

Ciwon ƙashin ƙugu

[gyara sashe | gyara masomin]

Ciwon da ke da alaƙa da ƙwanƙolin ƙashin ƙugu (PGP) ciwo ne da ke faruwa tsakanin ƙashin bayan iliac da kuma ƙashin bayan ƙashin ƙugu, wanda ke faruwa a farkon lokacin haihuwa ko kuma bayan haihuwa, wanda rashin kwanciyar hankali da kuma ƙarancin motsi ke haifarwa. Yana da alaƙa da ciwon pubic symphysis da kuma wani lokacin radiation na ciwo a ƙugu da cinyoyi. Ga yawancin masu juna biyu, PGP yana warkewa cikin watanni uku bayan haihuwa, amma ga wasu, yana iya ɗaukar shekaru, wanda ke haifar da raguwar haƙuri ga ayyukan ɗaukar nauyi. PGP yana shafar kusan kashi 45% na mutane a lokacin daukar ciki: kashi 25% suna ba da rahoton ciwo mai tsanani, kuma kashi 8% suna da nakasa sosai. [18] [19] Abubuwan da ke haifar da ci gaban rikitarwa sun haɗa da yawan kiba, ƙaruwar BMI, aiki mai wahala, shan taba, damuwa, tarihin rauni na baya da ƙashin ƙugu, da tarihin ciwon ƙashin ƙugu da na ƙasa. Wannan ciwon yana faruwa ne sakamakon girma a mahaifa yayin daukar ciki wanda ke haifar da ƙaruwar damuwa a yankunan lumbar da ƙashin ƙugu na uwa, wanda ke haifar da canje-canje a matsayi da rage ƙarfin tsokoki na lumbopelvic, wanda ke haifar da rashin kwanciyar hankali da ciwo. Ba a san ko takamaiman hormones a cikin daukar ciki suna da alaƙa da ci gaban rikitarwa ba. PGP na iya haifar da rashin ingancin rayuwa, rashin yiwuwar kamuwa da ciwon da ke damunsa, tsawaita hutu daga aiki, da kuma damuwa ta zamantakewa . Akwai zaɓuɓɓukan magani da yawa dangane da tsananin alamun. Zaɓuɓɓukan magani marasa cutarwa sun haɗa da gyaran aiki, tufafin tallafi na ƙashin ƙugu, maganin rage zafi tare da ko ba tare da ɗan gajeren hutun gado ba, da kuma motsa jiki don ƙara ƙarfin tsokoki na gluteal da adductor, rage damuwa a kan kashin baya na lumbar. Ana ɗaukar kulawar tiyata mai tsanani a matsayin magani na ƙarshe idan duk sauran hanyoyin magani sun gaza kuma alamun sun yi tsanani. [19]

Hawan jini

[gyara sashe | gyara masomin]

Matsalolin hawan jini masu tsanani da ka iya tasowa a lokacin daukar ciki sun hada da:

  • Pre-eclampsia - hauhawar jini a lokacin daukar ciki, proteinuria (>300) mg), da kuma kumburi . Ciwon pre-eclampsia mai tsanani ya ƙunshi hawan jini sama da 160/110 (tare da ƙarin alamu). Yana shafar kashi 5-8% na masu juna biyu.
  • Eclampsia - farfadiya a cikin majiyyaci kafin a fara zubar da ciki, wanda ke shafar kusan kashi 1.4% na masu juna biyu. [20]
  • Hawan jini na ciki zai iya tasowa bayan makonni 20 amma ba shi da wasu alamu kuma yana iya warwarewa, amma yana iya zama pre-eclampsia. [21]
  • Ciwon HELLP - Anemia mai ɗauke da sinadarin hemolytic, yawan enzymes na hanta da kuma ƙarancin adadin platelets . An ruwaito cewa lamarin ya faru ne kashi 0.5–0.9% na dukkan masu juna biyu. [22]
  • Hanta mai tsanani a lokacin daukar ciki wani lokacin ana samunta a cikin pre-eclamptic spectrum. Yana faruwa a kimanin daya cikin 7,000 zuwa daya cikin 15,000 ciki. [23] [24]

Matan da ke fama da hawan jini na yau da kullun kafin su yi ciki suna cikin haɗarin kamuwa da matsaloli kamar haihuwa da wuri, ƙarancin nauyin haihuwa, ko haihuwa gawa . [25] Matan da ke fama da hawan jini kuma suka sami matsaloli a cikin ciki suna da haɗarin kamuwa da cututtukan zuciya sau uku idan aka kwatanta da mata masu hawan jini na yau da kullun waɗanda ba su da wata matsala a cikin ciki. Kula da hawan jini na mata masu juna biyu zai iya taimakawa wajen hana rikitarwa da cututtukan zuciya na gaba. [26] [27]

Thromboembolism na jijiyoyin jini

[gyara sashe | gyara masomin]

Ciwon jijiyoyin jini, wanda ya ƙunshi ciwon jijiyoyin jini mai zurfi da kuma ciwon huhu, babban abin da ke haifar da rashin lafiya da mace-mace bayan haihuwa, musamman a ƙasashe masu tasowa. Haɗarin yawan zubar jini da ke ƙaruwa da juna biyu da ƙarin abubuwan haɗari kamar kiba da ciwon jijiyoyin jini yana sa mata masu juna biyu su kasance cikin haɗarin kamuwa da cututtukan jijiyoyin jini [28] Matakan rigakafi waɗanda suka haɗa da amfani da heparin mai ƙarancin nauyin kwayoyin halitta na iya rage haɗarin da ke tattare da tiyata, musamman ga marasa lafiya masu haɗarin kamuwa da cutar. Sanin kai tsakanin masu ba da kulawa da gaggawa da kuma amsawa cikin gaggawa wajen gano da kuma kula da ciwon jijiyoyin jini da wuri yayin daukar ciki da kuma bayan haihuwa suna da mahimmanci don amsawa cikin gaggawa . Ciwon jijiyoyin jini mai zurfi, wani nau'in ciwon jijiyoyin jini, yana da yawan faruwa tsakanin 0.5 zuwa 7 a cikin kowace ciki 1,000, kuma shine na biyu mafi yawan sanadin mutuwar mata masu juna biyu a ƙasashe masu tasowa bayan zubar jini.

  • Ya haifar da : Yawan zubar jini da ke haifar da ciki a matsayin martanin jiki a shirye-shiryen zubar jini mai yuwuwa yayin haihuwa .
  • Magani : Ana iya nuna maganin rigakafi, misali, tare da ƙarancin nauyin ƙwayoyin halitta na heparin idan akwai ƙarin abubuwan haɗari ga thrombosis na jijiyoyin jini masu zurfi. [29]

Rashin jini

[gyara sashe | gyara masomin]

Rashin jini matsala ce da aka sani a duniya a fannin daukar ciki kuma cuta ce da ke da ƙarancin sinadarin haemoglobin a cikin ɗaya daga cikin watanni uku na ciki. Irin waɗannan canje-canje na jiki sun fi bayyana a tsakanin mutanen da ke fama da ƙarancin abinci mai gina jiki da kuma cututtuka na yau da kullun da ke da alaƙa da komawar haemoglobin, kamar cutar sikila. Rigakafin rashin jini a lokacin daukar ciki yana da rikitarwa kuma galibi ana magance shi ta hanyar haɗin gwiwa na ƙarin abinci, maganin ƙarfe, da kuma ci gaba da kimanta ma'aunin uwa da tayi ta hanyar amfani da hanyoyi daban-daban. [30] A matsayin ƙarin ma'auni, ana mai da hankali kan tantance wuraren da ke haifar da hakan, da kuma amfani da kulawar da ta dace a lokacin daukar ciki don samun sakamako mafi kyau ga uwa da tayin.

Matakan haemoglobin sun yi ƙasa a cikin watanni uku na uku. A cewar kiyasin Majalisar Dinkin Duniya (MDD), kusan rabin masu juna biyu suna kamuwa da cutar anemia a duk duniya. Kimanin rabin mata masu juna biyu suna fuskantar karancin ƙarfe tare da ko ba tare da cutar anemia ba. [31] Yawan cutar anemia a lokacin daukar ciki ya bambanta daga kashi 18% a ƙasashen da suka ci gaba zuwa kashi 75% a Kudancin Asiya; wanda ya kai ga adadin kashi 38% na masu juna biyu a duniya. [1] [4]

Maganin ya bambanta saboda tsananin rashin isasshen jini, kuma ana iya cimma shi ta hanyar ƙara yawan abinci mai ɗauke da ƙarfe, allunan ƙarfe na baki, ko kuma ta hanyar amfani da sinadarin iron na parenteral . [13]

Kamuwa da cuta

[gyara sashe | gyara masomin]

Ciki lokaci ne mai matuƙar muhimmanci ga uwa mai ciki ta fuskanci ƙarin haɗari da ke tattare da kamuwa da cuta. Bugu da ƙari, lafiyar uwa da jariri na fuskantar haɗari lokacin da take cikin wannan yanayin. Rikicewar yanayin jiki na lokacin haihuwa da kuma daidaita garkuwar jiki suna ƙara haɗarin kamuwa da mura, hepatitis E, da kuma kamuwa da cutar cytomegalovirus. Ana iya ba da fifiko ga matakan gujewa kamar alluran rigakafi da ƙa'idojin kula da kamuwa da cuta a cikin manufofin da ke da nufin iyakance haɗarin kamuwa da cuta a tsakanin mutanen da ke cikin haɗarin kamuwa da cuta. Bugu da ƙari, gano cutar da wuri da kuma kula da cututtukan uwa suna daga cikin manyan hanyoyin hana kamuwa da cuta a tsaye da kuma canje-canje a cikin tayin.

Mace mai juna biyu ta fi saurin kamuwa da wasu cututtuka . Wannan ƙaruwar haɗarin yana faruwa ne sakamakon ƙaruwar juriyar garkuwar jiki a lokacin daukar ciki don hana amsawar garkuwar jiki ga tayin, da kuma canje-canje a cikin yanayin jiki na uwa, gami da raguwar yawan numfashi da kuma rashin isasshen fitsari saboda girman mahaifa. [32] Mutane masu juna biyu suna fuskantar mummunar illa ta hanyar, misali, mura, hepatitis E, herpes simplex da malaria . [32] Shaidar ta fi iyakance ga coccidioidomycosis, kyanda, smallpox, da varicella . [32] Mastitis, ko kumburin nono, yana faruwa a cikin kashi 20% na mutanen da ke shayarwa. [33]

Wasu cututtuka ana iya yaɗa su a tsaye, ma'ana suna iya shafar yaron ma. [34]

Ciwon zuciya na peripartum

[gyara sashe | gyara masomin]

Ciwon zuciya na Peripartum wani ciwon zuciya ne da ke faruwa sakamakon raguwar kashi na ƙwanƙwasa na hagu (LVEF) zuwa ƙasa da kashi 45%, wanda ke faruwa a ƙarshen ciki ko watanni kaɗan bayan haihuwa. Alamomin sun haɗa da ƙarancin numfashi a wurare daban-daban da/ko tare da aiki tuƙuru, gajiya, kumburin ƙafa, da matsewar ƙirji. Abubuwan da ke tattare da haɓakar wannan matsala sun haɗa da shekarun uwa sama da shekaru 30, ciki mai yawan haihuwa, tarihin iyali na ciwon zuciya, ganewar cutar zuciya a baya, pre-eclampsia, hauhawar jini, da asalin Afirka. Ba a san ainihin cutar cututtukan zuciya na peripartum ba tukuna; duk da haka, ana ba da shawarar cewa abubuwan da ke haifar da cututtuka da yawa na iya haɗawa da hanyoyin autoimmune, myocarditis na ƙwayar cuta, ƙarancin abinci mai gina jiki, da canje-canje na zuciya da jijiyoyin jini, waɗanda ke ƙara yawan ƙwanƙwasa zuciya. Ciwon zuciya na peripartum na iya haifar da matsaloli da yawa kamar kamawar zuciya, kumburin huhu, thromboembolisms, raunin kwakwalwa, da mutuwa. Maganin wannan yanayin yayi kama da maganin marasa lafiya da ke fama da ciwon zuciya; duk da haka, dole ne a ba da fifiko ga amincin tayin. Misali, don hana zubar jini saboda karuwar haɗarin thromboembolism, ana amfani da heparin mai ƙarancin nauyin kwayoyin halitta, wanda yake da aminci don amfani a lokacin daukar ciki, maimakon warfarin, wanda ke ratsa mahaifa. [35]

Ciwon thyroid

[gyara sashe | gyara masomin]

Hypothyroidism (wanda cutar Hashimoto ke haifarwa) cuta ce ta garkuwar jiki wadda ke shafar thyroid ta hanyar haifar da ƙarancin matakan hormones na thyroid. Alamomin hypothyroidism na iya haɗawa da ƙarancin kuzari, rashin haƙuri a cikin sanyi, maƙarƙashiya a cikin tsoka, maƙarƙashiya, da matsalolin ƙwaƙwalwa da tattara hankali. [36] Ana gano shi ta hanyar kasancewar matakan hormone mai motsa thyroid ko TSH. Marasa lafiya da ke da TSH mai yawa da raguwar matakan free thyroxine ko T4 ana ɗaukar su suna da hypothyroidism a bayyane. Waɗanda ke da TSH mai yawa da matakan yau da kullun na free T4 ana ɗaukar su suna da hypothyroidism a ƙarƙashin kulawa. [37] Abubuwan da ke haifar da haɓakar hypothyroidism a lokacin daukar ciki sun haɗa da ƙarancin iodine, tarihin cutar thyroid, goiter da ake gani, alamun hypothyroidism, tarihin iyali na cututtukan thyroid, tarihin ciwon sukari na nau'in 1 ko yanayin autoimmune, da tarihin rashin haihuwa ko asarar tayi. Daban-daban hormones a lokacin daukar ciki suna shafar thyroid kuma suna ƙara buƙatar hormones na thyroid. Misali, a lokacin daukar ciki, akwai ƙaruwar fitar iodine daga fitsari da kuma ƙaruwar thyroxine binding globulin da lalacewar hormones na thyroid, wanda duk yana ƙara buƙatar hormones na thyroid. [38] Wannan yanayin na iya yin tasiri sosai ga uwa da tayin yayin daukar ciki. Jaririn na iya fuskantar matsala sosai kuma yana da nakasa iri-iri na haihuwa. Matsalolin da ke tattare da uwa da tayin na iya haɗawa da pre-eclampsia, anemia, zubar da ciki, ƙarancin nauyin haihuwa, haihuwa a cikin mamaci, gazawar zuciya, lalacewar ci gaban kwakwalwa, da kuma, idan ya yi tsanani, rashin sinadarin iodine a cikin mahaifa . [36] [38] Ana magance wannan matsalar ta hanyar ƙara sinadarin iodine, levothyroxine, wanda wani nau'i ne na maye gurbin hormones na thyroid, da kuma sa ido sosai kan aikin thyroid. [38]

Hanta mai kitse mai tsanani a lokacin daukar ciki

[gyara sashe | gyara masomin]

Hanta mai kitse mai tsanani (ALFP) matsala ce mai matuƙar wahala amma mai tsanani da ke faruwa a cikin ciki wadda ke iya haifar da rashin lafiya ko mace-mace mai yawa ga uwa da tayin. AFLP yana faruwa ne lokacin da kitse ya taru a cikin hanta. Ana tsammanin yana faruwa ne sakamakon tarin ƙwayoyin kitse a cikin ƙwayoyin halitta masu rai saboda rashin aikin mitochondrial a cikin rushewar kitse (fatty acid β-oxidation). Wannan na iya hana hanta aiki yadda ya kamata; duk da haka, ba a fahimci ainihin hanyarsa ba. [39] Ana samun goyan bayan ganewar asali ta hanyar binciken da ba a saba gani ba na hanta ko kuma shigar ƙwayoyin halitta na ƙwayoyin halitta na hanta. AFLP na iya haifar da alamun gajiya mai yawa, amai, ciwon ciki, ko jaundice. Mutane kuma na iya samun ƙarancin sukari a jini, wahalar tunani a sarari, ko matsalolin zubar jini.

Takaitaccen bayani game da alamomi da kuma alamun

  •      Vomiting
  •      Abdominal pain
  •      Excessive thirst/urination
  •      Encephalopathy

AFLP gaggawa ce ta lafiya kuma tana buƙatar haihuwa cikin gaggawa. Yaran da iyaye mata masu fama da ALFP ke da haɗarin kamuwa da ƙarancin sukari a jini, ciwon zuciya mai faɗaɗa, ciwon jijiyoyi, da kuma mutuwar jarirai kwatsam. [40] [41]

Sharuɗɗan Swansea don gano cutar AFLP. Kasancewar masu canji marasa kyau ≥6 yana da ƙimar hasashen mai kyau na 85% da ƙimar hasashen mara kyau na 100% don gano steatosis na ƙwayoyin cuta na microvascular: [42]

Alamomi da Alamomi 1. Amai
2. Ciwon ciki
3. Polydipsia/polyuria
4. Ciwon kwakwalwa
Sakamakon dakin gwaje-gwaje 5. Bilirubin mai yawa ( >0.8 mg/dL)
6. Yawan sukari (glucose < 72) mg/dL)
7. Leukocytosis (> ƙwayoyin halitta 11,000/microL)
8. Transaminases masu ƙaruwa (AST ko ALT) (>42 naúrar ƙasa da ƙasa/L)
9. Ammonia mai yawa ( >47 micromol/L)
10. Urate mai yawa (5.7) mg/dL)
11. AKI ko Creatinine >1.7 mg/dl
12. Ciwon Coagulopathy ko lokacin prothrombin > daƙiƙa 14
Hoto 13. Hanta mai haske ko kuma hanta mai haske a lokacin daukar hoton duban dan tayi (ultrasound scan)
Ilimin Halittar Halitta 14. Microvesicular steatosis akan biopsy na hanta

AFLP na iya haifar da gazawar hanta mai tsanani. Matsalar hanta mai tsanani gaggawa ce ta likita, kuma an nuna cewa ganowa da kuma magance ta da sauri ta hanyar dialysis, haihuwa, da sauran matakan tallafi suna rage haɗarin kamuwa da matsalolin uwa da tayin. [43]

Matsalolin tayi da mahaifa

[gyara sashe | gyara masomin]

Matsalolin da ke tafe suna faruwa ne a cikin tayin ko mahaifa, amma kuma suna iya haifar da mummunan sakamako ga uwar.

Ciki a cikin mahaifa

[gyara sashe | gyara masomin]

Ciki a waje da mahaifa (ectopic pregnancy) shine dasawa da tayi a wajen mahaifa. Wannan nau'in ciki mai rikitarwa, wanda shine dasa ƙwai wanda aka saba da shi a wani wuri banda mahaifa, ya ƙunshi gazawar aiki, wanda zai iya haifar da yanayi mai barazana ga rayuwa. Duk da haka, ba a san ainihin dalilan da ke haifar da hakan ba. Wannan lamari galibi yana tare da cutar kumburin ƙashin ƙugu (PID), ko kuma tiyatar salpingectomy (tiyata).

  • Wanda ya haifar da : Abubuwan da ba a sani ba, amma masu haɗari sun haɗa da shan taba, shekarun uwa masu tasowa, da kuma tiyatar da aka yi a baya ko kuma rauni ga bututun mahaifa .
  • Abubuwan da ke haifar da haɗari sun haɗa da cutar kumburin ƙashin ƙugu da ba a yi magani ba, wataƙila saboda tabon bututun fallopian. [44]
  • Magani: A mafi yawan lokuta, dole ne a yi tiyatar ramin maɓalli don cire tayin, tare da bututun fallopian. Idan cikin ya yi wuri sosai, yana iya wargajewa da kansa, ko kuma ana iya magance shi da methotrexate, wani maganin hana zubar da ciki . [45]

ɓarin ciki

[gyara sashe | gyara masomin]

Zubar ciki shine asarar ciki kafin makonni 20. [46] A Burtaniya, zubar ciki ana bayyana shi a matsayin asarar ciki a cikin makonni 23 na farko. [47] Cikakken tallafi, ya ƙunshi tuntuɓar likitocin kwayoyin halitta da kuma samar da ayyukan likita ko tiyata da ake buƙata. Muhimmancin tunanin 'yan uwa, dangi, da abokai ga waɗanda aka yi wa rasuwa shi ma yana da mahimmanci. Kayan aiki mafi inganci da za a iya amfani da su don rage tasirin tunani na masu makoki sun haɗa da gwajin gawawwaki da ba da shawara kan baƙin ciki .

Kimanin kashi 80% na rashin ciki yana faruwa ne a farkon watanni uku na ciki, tare da raguwar haɗarin bayan makonni 12 na ciki. Wasu canje-canje, kamar tsufa ko rashin daidaituwar ƙwayoyin halitta, suna da yuwuwar haifar da zubar da ciki da yawa . [48] Za a iya ƙara rarraba zubar da ciki ba zato ba tsammani zuwa cikakkun zubar da ciki, ba makawa, rasa, da kuma barazanar zubar da ciki:

  • Cikakken Jini: Jinin farji yana faruwa, sannan kuma samfuran ɗaukar ciki gaba ɗaya suna wucewa ta cikin mahaifa.
  • Babu makawa: Zubar jini a farji yana faruwa; an rufe mahaifar, wanda ke nuna cewa samfuran ɗaukar ciki za su shuɗe nan ba da jimawa ba.
  • An rasa: Zubar da jini a farji yana faruwa, kuma wasu samfuran ciki na iya wucewa ta cikin mahaifa; an rufe murfin mahaifa, kuma duban dan tayi yana nuna tayin da ba zai iya rayuwa ba da sauran samfuran ciki.
  • Barazanar: Zubar da jini a farji yana faruwa; an rufe mahaifar, kuma na'urar daukar hoton bidiyo tana nuna tayin da zai iya rayuwa.

Haihuwar Matacce

[gyara sashe | gyara masomin]

Ana bayyana haihuwar da ba a haifa ba a matsayin asarar tayi ko mutuwa bayan makonni 20 na ciki. Haihuwar da ba a haifa ba da wuri tana tsakanin makonni 20 zuwa 27 na ciki, yayin da haihuwar da ba a haifa ba da daɗewa ba tana tsakanin makonni 28 zuwa 36 na ciki. Kalmar haihuwar da ba a haifa ba ita ce lokacin da tayin ya mutu makonni 37 zuwa sama. [49] Wannan lamari na iya wuce baƙin ciki kuma yana iya haifar da damuwa game da abubuwan da ba a saba gani ba na uwa ko maganin bayan haihuwa game da rikitarwa na haihuwa. [50] Irin waɗannan iyaye za su buƙaci fiye da tausayi; gabaɗaya, ya kamata a yi la'akari da shirye-shiryen likita masu dacewa ga iyaye waɗanda ke da irin wannan baƙin ciki mai wahala. Tare da taimakon tabin hankali, shawara, da tallafin takwarorinsu, wanda ya kamata ya zama da amfani wajen taimaka wa iyaye waɗanda suka rasa 'ya'yansu.

  • Ilimin Cututtuka: Akwai haihuwar jarirai sama da miliyan 2 da aka kashe a shekara kuma akwai haihuwar jarirai kimanin 6 da aka kashe a cikin kowace haihuwa 1000 (0.6%) [51]
  • Gabatarwa ta Asibiti: Canje-canje a halayen tayi kamar raguwar motsi ko rashin jin daɗin tayi na iya nuna haihuwar da ba a haifa ba, amma gabatarwar na iya bambanta sosai.
  • Abubuwan da ke haifar da haɗari: Nauyin uwa, shekaru, da shan taba, da kuma ciwon suga ko hawan jini na uwa da ya riga ya faru [49]
  • Magani: Idan haihuwa ta faru kafin haihuwa, zaɓuɓɓukan magani sun haɗa da naƙuda ko kuma tiyatar cesarean. In ba haka ba, haihuwar da ba a haifa ba za ta iya wucewa da haihuwa ta halitta.

Rushewar mahaifa

[gyara sashe | gyara masomin]

Faɗuwar mahaifa, wanda aka bayyana a matsayin rabuwar mahaifa daga mahaifa kafin haihuwa, babban abin da ke haifar da zubar jini a farji a cikin watanni uku na uku kuma yana rikitar da kusan kashi 1% na ciki. [13] [52] Bayyanar cututtuka suna da bambanci: Wasu mata za su iya yin watsi da alamun gaba ɗaya, yayin da wasu kuma suna da ɗan zubar jini ko rashin jin daɗi a ciki da ciwo. Saboda haka, duk da cewa bambancin tsananin alamun da rabuwar mahaifa ba su da mahimmanci, har yanzu suna iya haifar da rikitarwa ga ganewar asali da kuma kula da lafiya.

Da yawa daga cikin masu taimakawa na iya haifar da zamewar mahaifa. Wannan ya haɗa da: abubuwan da suka shafi uwa da ta riga ta kasance (misali, shan taba, hawan jini, tsufa), [53] da kuma abubuwan da suka shafi ciki kamar ɗaukar ciki da yawa ko kasancewar kamuwa da cututtukan cikin mahaifa . Gano abubuwan da ke haifar da haɗari kafin a ɗauki matakai da kuma yin gaggawar amsawa don rage yuwuwar sakamako mara kyau ga uwa ko tayin yana da mahimmanci. Dabaru na maganin karyewar mahaifa sun dogara ne akan shekarun ɗaukar ciki na tayi da kuma matsayin uwa da jariri. Ya kamata a ba da izinin haihuwa nan take ga jarirai na cikakken lokaci (makonni 36 ko fiye) da kuma idan akwai damuwa. Ana sa ido sosai kan lamuran da suka shafi tayin da ba su kai ba, kuma ana yin duk wani taimako da ya wajaba a cikin lokaci bayan an lura da kyau.

Matakan rigakafi, waɗanda suka haɗa da ba da shawara kafin ɗaukar ciki don magance abubuwan da za a iya gyarawa, na iya rage yawan faruwar fashewar mahaifa. Sanin tasirin dogon lokaci ga uwa da jariri bayan haihuwa yana da mahimmanci. Ci gaba da bincike da hanyoyin da suka dogara da shaida suna taimakawa wajen samar da kulawa da ke aiki. Haɗin gwiwa tsakanin masu samar da lafiya da marasa lafiya shine ginshiƙin sakamakon fashewar mahaifa.

  • Gabatarwa ta Asibiti: Ya bambanta sosai daga rashin alamun cutar zuwa zubar jini ta farji da ciwon ciki.
  • Abubuwan da ke haifar da haɗari: Ba zato ba tsammani kafin a fara jima'i, shan taba, rauni, amfani da hodar iblis, ɗaukar ciki da yawa, hawan jini, preeclampsia, thrombophilia, shekarun haihuwa masu tasowa, fashewar membranes da wuri kafin a fara jima'i, kamuwa da cututtukan da ke cikin mahaifa, da kuma hyramnios.
  • Magani: Haihuwa nan take idan tayin ya girma (makonni 36 ko sama da haka), ko kuma idan ƙaramin tayin ko uwar tana cikin damuwa. A cikin lokuta marasa tsanani tare da tayin da bai kai ba, ana iya sa ido kan halin da ake ciki a asibiti, tare da magani idan ya cancanta.

Tsarin Placenta

[gyara sashe | gyara masomin]

Placenta previa cuta ce da ke faruwa idan mahaifa ta rufe mahaifa gaba ɗaya ko kuma wani ɓangare. [13] Placenta previa za a iya ƙara rarraba ta zuwa cikakken previa, partial previa, gender previa, da ƙananan mahaifa, ya danganta da matakin da mahaifar ta rufe mahaifar ciki. Ana gano Placenta previa ta hanyar amfani da na'urar duban dan tayi, ko dai a lokacin gwaji na yau da kullun ko bayan wani zubar jini na farji mara kyau, sau da yawa a cikin trimester na biyu na ciki. Yawancin shari'o'in previa na placenta ana gano su ne a lokacin trimester na biyu. [ <span title="This claim needs references to reliable sources. (March 2023)">ana buƙatar ambato</span> ]

Ana daidaita jiyya gwargwadon tsananin su da kuma yanayin lafiyar uwar, tun daga sa ido sosai har zuwa tiyatar caesarean.

  • Abubuwan da ke Haɗari: haihuwar da aka yi kafin a yi tiyatar haihuwa, ƙarshen ciki, tiyatar da aka yi a cikin mahaifa, shan taba, ɗaukar ciki da yawa, ƙaruwar daidaito, shekarun uwa. [54]

Placenta Accreta

[gyara sashe | gyara masomin]

Placenta accreta wani nau'in mannewa ne na mahaifa wanda ba shi da kyau ga bangon mahaifa. [55] Musamman, placenta accreta ya ƙunshi mannewa na trophoblast na mahaifa wanda ba shi da kyau ga myometrium na mahaifa. [56]

Abubuwan da ke haifar da haɗarin kamuwa da cutar placenta sun haɗa da previa na placenta, ƙaruwar AFP a cikin watanni uku na biyu da matakan β-hCG kyauta, da kuma ci gaba da shekarun iyaye masu juna biyu, musamman sama da shekaru 35. [57] Bugu da ƙari, haihuwar caesarean kafin haihuwa yana ɗaya daga cikin abubuwan da ke haifar da accreta na placenta saboda kasancewar tabon mahaifa wanda ke haifar da rashin daidaituwa na placenta. [58]

Saboda mannewar mahaifa ba daidai ba a bangon mahaifa, sau da yawa ana nuna haihuwar mahaifa, da kuma tiyatar cire mahaifa. [56]

WManazarta

[gyara sashe | gyara masomin]
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  2. ↑ Lozano, Rafael; Naghavi, Mohsen; Foreman, Kyle; Lim, Stephen; Shibuya, Kenji; Aboyans, Victor; Abraham, Jerry; Adair, Timothy; Aggarwal, Rakesh; Ahn, Stephanie Y; AlMazroa, Mohammad A; Alvarado, Miriam; Anderson, H Ross; Anderson, Laurie M; Andrews, Kathryn G (2012-12-15). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". The Lancet. 380 (9859): 2095–2128. doi:10.1016/s0140-6736(12)61728-0. ISSN 0140-6736. PMC 10790329 Check |pmc= value (help). PMID 23245604.
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  42. ↑ Desai, Anshuman; McNair, Jasmine; Ebiai, Ruona; Bzowej, Natalie (October 2024). "S4161 A Rare Case of Postpartum Acute Fatty Liver of Pregnancy". American Journal of Gastroenterology (in Turanci). 119 (10S): S2688–S2689. doi:10.14309/01.ajg.0001046012.65455.9c. ISSN 0002-9270.
  43. ↑ Paulina, Banach; Kuczkowska, Justyna; Areshchanka, Yulia; Banach, Weronika; Rzepka, Jakub; Kudliński, Bartosz; Rzepka, Rafał (2025-03-17). "Acute Liver Failure During Early Pregnancy—Case Report and Review of Literature". Journal of Clinical Medicine (in Turanci). 14 (6): 2028. doi:10.3390/jcm14062028. ISSN 2077-0383. PMC 11942626 Check |pmc= value (help). PMID 40142836 Check |pmid= value (help).
  44. ↑ Lemire F (October 2021). "[Not Available]". Canadian Family Physician. 67 (10): 791. doi:10.46747/cfp.6710791. PMC 8516186 Check |pmc= value (help). PMID 34649907 Check |pmid= value (help). S2CID 238861265 Check |s2cid= value (help).
  45. ↑ "Ectopic pregnancy – Treatment – NHS Choices". www.nhs.uk. Archived from the original on 2017-08-19. Retrieved 2017-07-27.
  46. ↑ "Pregnancy complications". www.womenshealth.gov. Archived from the original on 2016-11-14. Retrieved 2016-11-13.
  47. ↑ "Miscarriage". NHS Choice. NHS. Archived from the original on 2017-02-15. Retrieved 2017-02-13.
  48. ↑ du Fossé, Nadia A; van der Hoorn, Marie-Louise P; van Lith, Jan M M; le Cessie, Saskia; Lashley, Eileen E L O (2020-05-02). "Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis". Human Reproduction Update. 26 (5): 650–669. doi:10.1093/humupd/dmaa010. PMC 7456349. PMID 32358607.
  49. 1 2 Marufu TC, Ahankari A, Coleman T, Lewis S (March 2015). "Maternal smoking and the risk of still birth: systematic review and meta-analysis". BMC Public Health. 15 (1). doi:10.1186/s12889-015-1552-5. PMC 4372174. PMID 25885887. S2CID 5241108.
  50. ↑ Page, J. M.; Silver, R. M. (2020). "Stillbirth - Obstetrics and Gynecology Clinics". Obstetrics and Gynecology Clinics of North America. 47 (3): 439–451. doi:10.1016/j.ogc.2020.04.008. PMID 32762929.
  51. ↑ Page JM, Silver RM (April 2018). "Evaluation of stillbirth". Current Opinion in Obstetrics & Gynecology. 30 (2): 130–135. doi:10.1097/GCO.0000000000000441. PMID 29489503. S2CID 3607787.
  52. ↑ Oyelese Y, Ananth CV (October 2006). "Placental abruption". Obstetrics and Gynecology. 108 (4): 1005–1016. doi:10.1097/01.aog.0000239439.04364.9a. PMID 17012465. S2CID 960903.
  53. ↑ Odendaal, Hein; Wright, Colleen; Schubert, Pawel; Boyd, Theonia K.; Roberts, Drucilla J.; Brink, Lucy; Nel, Daan; Groenewald, Coen (October 2020). "Associations of maternal smoking and drinking with fetal growth and placental abruption". European Journal of Obstetrics & Gynecology and Reproductive Biology. 253: 95–102. doi:10.1016/j.ejogrb.2020.07.018. PMID 32862031.
  54. ↑ Oyelese Y, Smulian JC (April 2006). "Placenta previa, placenta accreta, and vasa previa". Obstetrics and Gynecology. 107 (4): 927–941. doi:10.1097/01.AOG.0000207559.15715.98. PMID 16582134. S2CID 22774083.
  55. ↑ Wortman AC, Alexander JM (March 2013). "Placenta accreta, increta, and percreta". Obstetrics and Gynecology Clinics of North America. 40 (1): 137–154. doi:10.1016/j.ogc.2012.12.002. PMID 23466142. |hdl-access= requires |hdl= (help)
  56. 1 2 Silver RM, Branch DW (April 2018). "Placenta Accreta Spectrum". The New England Journal of Medicine. 378 (16): 1529–1536. doi:10.1056/NEJMcp1709324. PMID 29669225. S2CID 81685472.
  57. ↑ Hung TH, Shau WY, Hsieh CC, Chiu TH, Hsu JJ, Hsieh TT (April 1999). "Risk factors for placenta accreta". Obstetrics and Gynecology. 93 (4): 545–550. doi:10.1016/S0029-7844(98)00460-8. PMID 10214831.
  58. ↑ "Placenta Accreta Spectrum". www.acog.org (in Turanci). Retrieved 2022-09-16.
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